Provider Demographics
NPI:1154376689
Name:VALLEY COMMUNITY AMBULANCE ASSOCIATION
Entity type:Organization
Organization Name:VALLEY COMMUNITY AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:GEE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:814-258-7800
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:PA
Mailing Address - Zip Code:16942-0280
Mailing Address - Country:US
Mailing Address - Phone:814-258-7800
Mailing Address - Fax:
Practice Address - Street 1:7125 STATE ROUTE 49
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:PA
Practice Address - Zip Code:16942
Practice Address - Country:US
Practice Address - Phone:814-258-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013921930003Medicaid
PA46180OtherGEISINGER HEALTH PLAN
221987OtherHEALTH AMERICA/ASSURANCE
221987OtherHEALTH AMERICA/ASSURANCE